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Journal of Hand and Microsurgery

Tetsushi Aizawa, Chiaki Inada, Satoshi Kubo, Shimpo Aoki, Ryuichi Azuma, Tomoharu Kiyosawa
No abstract text is available yet for this article.
August 2018: Journal of Hand and Microsurgery
Feiran Wu, Asim Rajpura, Dilraj Sandher
Introduction de Quervain's tenosynovitis is a common pathologic condition of the hand. Finkelstein's test has long been considered to be a pathognomonic sign of this diagnosis, yet most clinicians and instruction manuals erroneously describe what is in fact the Eichhoff's test, which is thought to produce similar pain by tendon stretching in a normal wrist. The purpose of this study was to compare Finkelstein's test with Eichhoff's test in asymptomatic individuals. Materials and Methods Thirty-six asymptomatic participants (72 wrists) were examined using both Finkelstein's and Eichhoff's tests with a minimum interval of 24 hours between the tests...
August 2018: Journal of Hand and Microsurgery
Farid Najd Mazhar, Tina Shoushtarizadeh, Alireza Mirzaei
Glomus tumors are glomus body neoplasms that most commonly occur in the subungual areas of the hand, typically characterized by small nodules associated with localized tenderness, cold sensitivity, and excruciating paroxysmal pain. Extradigital glomus tumors can present a diagnostic challenge because they are rare and usually accompanied by nonspecific symptoms. Intravenous origin of the glomus tumor, especially in the wrist, is much rarer. The authors here report an intravenous glomus tumor of the wrist presented with atypical features such as insensitivity to cold and a history of long-term pain, which led to the misdiagnosis of the lesion as extensor tendonitis...
August 2018: Journal of Hand and Microsurgery
Jason S Hoellwarth, Robert J Goitz
Background Lipofibromatous hamartoma (LFH) is a benign tumor of peripheral nerves, most commonly reported in the median nerve, and often associated with carpal tunnel symptoms. There have been nearly 200 reported cases of LFH in the median nerve, but to the authors' knowledge, this 10-year-old girl represents the first case report involving the palmar cutaneous branch. Methods An excisional biopsy of the mass was performed via a standard midline palmar incision. The tumor was found encapsulating the palmar cutaneous branch, and thus it was sacrificed...
August 2018: Journal of Hand and Microsurgery
Ryosuke Sato, Naohito Hibino, Masahiro Yamano, Shinji Yoshioka, Tomoya Terai, Kenichiro Kita, Shingo Hama, Yoshitaka Hamada, Ichiro Tonogai, Koichi Sairyo
Reconstruction is challenging in a patient with loss of a segment of Achilles tendon and infection in the overlying soft tissue. Here the authors describe one-stage tendon reconstruction, using an anterolateral thigh free flap incorporating a vascularized muscle flap and a strip of iliotibial tract in a patient with re-rupture of an Achilles tendon and soft tissue infection. Postoperative immobilization of the affected ankle using an external fixator enabled us to observe the flap directly and reduce pressure on the flap...
August 2018: Journal of Hand and Microsurgery
Elizabeth M Kenny, Francesco M Egro, Tahsin Oğuz Acartürk
Lipomas are a common finding often of little clinical significance, but they can pose a challenge to the microsurgeon if discovered during flap harvesting, especially if found within the muscle along the pedicle or perforators. Here the authors report a case in which a well-circumscribed intramuscular lipoma was discovered within the muscle of a free myocutaneous right anterolateral thigh (ALT) vastus lateralis free flap. To the authors' knowledge, the management of lipoma during flap harvesting has not been previously discussed in the literature...
August 2018: Journal of Hand and Microsurgery
Zhi Yang Ng, Alan Shamrock, David L Chen, Seth D Dodds, Harvey Chim
Purpose To describe the various patterns of complex carpal and metacarpal fracture dislocations observed in a consecutive series of firework injuries and the operative management performed. Materials and Methods We performed a retrospective study of seven consecutive patients (six males; mean age = 22 ± 13, range, 8-39 years) who presented to a level I trauma center with firework injuries to the hand between July 2014 and January 2016. Results All injuries were sustained while a lighted firework was held in the hand...
August 2018: Journal of Hand and Microsurgery
S Nicholson, R H Milner, M Ragbir
Soft tissue sarcomas (STSs) of the hand and wrist are rare and confer a unique set of management challenges. We present a 15-year review and discussion of the epidemiology, tumor characteristics, treatment, and reconstructive strategies for such cases presenting to our regional sarcoma service. Three case examples are described. Of 218 STSs of the upper limb, 17 involved the hand or wrist. Alveolar rhabdomyosarcoma, synovial, and myxofibrosarcoma were the most common ones. Two patients required amputation for recurrence...
August 2018: Journal of Hand and Microsurgery
Daniel P Quinn, Alex Gu, Jeffrey A Greenberg, Thomas J Fischer, Gregory A Merrell
Background Cubital tunnel syndrome is the second most common upper extremity peripheral nerve entrapment syndrome. In particular, cubital tunnel has been documented occasionally in young, throwing athletes. Materials and Methods Billing databases were searched for patients undergoing surgical decompression of the ulnar nerve at the elbow, who were age 18 or younger at the time of surgery. Charts were reviewed and patients were included if they had an isolated mononeuropathy consistent with cubital tunnel syndrome and were symptomatic...
August 2018: Journal of Hand and Microsurgery
Tiffany R Kadow, Robert A Kaufmann, Robert J Goitz, John R Fowler
Purpose Additional methods of diagnosing carpal tunnel syndrome (CTS) are increasingly being investigated, such as ultrasound or diagnostic tools such as carpal tunnel syndrome 6 (CTS-6), and the sensitivity and specificity of these tests are determined by the pretest probably and thereby the prevalence of a condition. It is critical that the prevalence used in these calculations accurately reflects the population undergoing these tests for a true assessment of their quality. Orthopaedic surgeons and, specifically, upper extremity specialists are most often studying these diagnostic methods, and given referral patterns, these physicians likely have a greater prevalence of CTS in their clinics than previously published for only the general population (5%)...
August 2018: Journal of Hand and Microsurgery
Thibault Lafosse, Pascal Jehanno, Frank Fitoussi
Study Design This is a retrospective cohort study. Objective The authors report surgical outcome in a series of very young children who underwent finger replantation after traumatic amputation. Methods During a 10-year period, 65 children were treated with replantation for finger amputation in two institutions. This study focused on replantation of 15 fingers in 13 young patients under 6 years of age (mean age: 2.9 years; range: 1.1-5.7 years). Early postoperative complications were categorized into major or minor...
August 2018: Journal of Hand and Microsurgery
Ashkaun Shaterian, Ramin Rajaii, Melissa Kanack, Gregory R D Evans, Amber Leis
Introduction Microsurgical replantation following digital amputation has variable success rates. Sociodemographic factors and surgery-related variables have been shown to influence survival rates; however, few studies have evaluated these data systematically across a combined dataset. Therefore, the objective of this study was to analyze the current literature to identify the predictors of replant survival. Materials and Methods A literature review was performed using the PubMed/Medline database focused on complete digit amputation/replantation studies...
August 2018: Journal of Hand and Microsurgery
Ryan Rebowe, Ashley Rogers, Xuebin Yang, S C Kundu, Thomas L Smith, Zhongyu Li
Nerve conduits are becoming increasingly popular for the repair of peripheral nerve injuries. Their ease of application and lack of donor site morbidity make them an attractive option for nerve repair in many situations. Today, there are many different conduits to choose in different sizes and materials, giving the reconstructive surgeon many options for any given clinical problem. However, to properly utilize these unique reconstructive tools, the peripheral nerve surgeon must be familiar not only with their standard indications but also with their functional limitations...
August 2018: Journal of Hand and Microsurgery
Ahmet Köse, Murat Topal, Recep Dinçer
No abstract text is available yet for this article.
April 2018: Journal of Hand and Microsurgery
Ji H Son, Christina Pindar, Hooman Soltanian
No abstract text is available yet for this article.
April 2018: Journal of Hand and Microsurgery
Alistair R M Macey, Roshin Thomas
The anatomy of the cords that form in Dupuytren's disease is complicated and a spiral cord is the most challenging variant to address. It displaces the neurovascular bundle toward or beyond the midline and closer to the skin. This article illustrates the surface anatomy of the neurovascular spiral to help surgeons identify this zone of danger that the authors term "the serpentine zone." Careful dissection in this zone will help avoid iatrogenic digital neurovascular injury.
April 2018: Journal of Hand and Microsurgery
Feiran Wu, Chye Yew Ng
We report an unusual anatomical variant of the palmar cutaneous branch (PCB) of the median nerve in a 46-year-old man presenting with recurrent carpal tunnel syndrome. At surgery, after neurolysis, the PCB was visualized arising at the level of the proximal margin of the transverse carpal ligament, mimicking the appearance of the recurrent motor branch. To date, there has been no description of this branch arising at this level. We aim to remind surgeons of this variation and highlight the importance of maintaining vigilance to avoid iatrogenic nerve injury...
April 2018: Journal of Hand and Microsurgery
Osman Kelahmetoglu, Mustafa Ekrem Gules, Nuh Mehmet Elmadag, Ethem Guneren, Selma Sonmez Ergun
Loss of the Achilles' tendon with overlying soft tissue and skin defects remains a complex reconstructive challenge. Herein we present our experience using a free composite anterolateral thigh (ALT) flap with vascularized fascia lata and a modified Lindholm's technique to repair the Achilles' tendon. A 37-year-old man suffered from tertiary Achilles' tendon rupture. For reconstruction, the free composite ALT flap with vascularized fascia lata was used to wrap Achilles' tendon. A modified Lindholm's technique was used to cover overlying soft tissue defects...
April 2018: Journal of Hand and Microsurgery
Debora Lana, Luigi Tarallo, Fabio Catani
Injuries of the triceps brachii muscle are a rare entity and mostly concern its distal tendon. These represent the least common of all muscle and tendons injuries. The most common reported causes are repeated strong physical efforts, a fall on an outstretched forearm when a sudden deceleration is put on contract triceps, or a direct trauma. High-dosed and prolonged corticosteroid therapies, repeated local steroid injections, chronic renal failure, diabetes, rheumatoid arthritis, hyperparathyroidism, and osteogenesis imperfecta are reported as systemic causes...
April 2018: Journal of Hand and Microsurgery
Anirban Chatterjee, Shamita Chatterjee
Subcutaneous and deep fungal infections in the hand are rare among children. These are usually found in immunocompromised adults or in persons engaged in soil handling activities, due to direct exposure, especially in the tropics. Delay in diagnosis is usual because pyogenic and other granulomatous infections are considered first. The authors present the case of a healthy, immunocompetent 2½-year-old child who presented with progressive swelling of the right hand mimicking a localized gigantism of the entire hand...
April 2018: Journal of Hand and Microsurgery
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